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FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
-4
Date ... MAr.Ch.... 15 .............. 19.16
THIS CERTIFIES that the building located at .11 60 .LOv.Q . LQAQ .......... Street
Map No ............. Block No. Lot No.... ..... .
REQUIREMENTS FOR ONE FAMILY DWELLING BUILT BEFORE
conforms substantially to the
CERTIFICATE OF OCCUPANCY
dated ...April ... 23 ....... , 19.5.7. pursuant to which --0 0.. 28957.
dated .. March ... 1.5 ......... 19 7.8., was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ..... PRIVATE ONE. FAMILY. DWELLING ...................................
The certificate is issued to .. Walter .&. Marilyn .Gatz ............................
(owner, 19Q9e i W=)
of the aforesaid building.
Suffolk County Department of Health Approval ....... Pre -Existing ..............
UNDERWRITERS CERTIFICATE No . ............... Pro—Existing ..............
HOUSE NUMBER ...11.60 ..... Street ....... Love. Lame.......................
............................................ lylQtt i tuck.... NY.................. .
`:,4. . � �,/
Building Inspector
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Clerks Office
Southold, N. Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building
Inspector with the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and
unusual natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal—(S-9 form or equal).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and
installations, a certificate of Code compliance from the Architect or Engineer responsible for
the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non -conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate survey of property showing all property lines, streets, buildings and unusual natural
or topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in-
formation required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00 January 11, 1978
Date................................................
New Building .................... Old or Pre-existing Building ........ X................. Vacant Land
............................
Location Of Property .. Love..Lane. j...Mattituck c„ New„ York ...........................
FORM
OOwner8r Owners Of Property..WALTER & MARILYN GATZ and DOROTHY HAMILTON
wner O.....................................................................................................................
Subdivision................................................................ Lot No. l4 & 16. Block No. ...1...... House No.............
PermitNo ..................... Date Of Permit ....................Applicant..................................................................
HealthDept. Approval ............................................Labor Dept. Approval ................................................
Underwriters Approval ..............................................Planning Board Approval ........................................
Request For Temporary Certificate ........................................ Final Certificate ..........................................
Fee Submitted $l..... 5.00......
Construcfian on ascribed building and gm'
t ets all applicable c s and regulations.
TER Applicant GATZ
Sworrn^ to';e'this
. days' .ski ..: 1978 (stamp or seal)
Nota lic ��' County 1//3/77
H� .... �c- y D y/
NOTARY PUBLIC, State of New YoA
No, 52-451688 1 -Suffolk County p� � 995-7 9 � '%
Commission Expires March 30, 147 ` r
Housing Code Inspection
March 10, 1978
1160 Love Lane R-1
Mattituck, NY
Tax Roll: Walter & Marilyn Gatz
occupied: Peter E.,& Deborah R. Orlowski
Upon receipt of an application for a Pre -Existing Certificate of
Occupancy I made an inspection of the buildings on this premises. I
was admitted to dwelling by Mrs. Orlowski who accompanied me during
this inspection that began at approximately 11:30 A.M.
The dwelling is a one story wood framed structure constructed on
a cement block foundation and contains three bedrooms, a living room,
kitchen and two bathrooms. Foundation provides a partial cellar with
crawl space. Heat is furnished to all rooms from an oil fired hotwater
furnace located on ground floor in utility room which is accessible
from exterior on east side of building. A wood frame three car garage
constructed on a concrete block foundation is located in rear yard
area.
The following violations of the Housing :Code, Chapter 52, Code
of the Town of Southold were found:
Entry: front hallway, no means of controlling light
in room at point of entry. Article V. Section 52-56
B.2.
Sewage system: no house trap. Article V. Section 52-
51 C.1.
Electrical: ground wire from buildings electrical
service panel, no ground clamp provided on water
main near water pump. Article V. Section 52-56 A.1-
2-5.
Structural: grider supported by two 4x4 wood posts
and a chimney flue tile. Wood posts are resting on
dirt floor, appears no footings are provided. Flue
tile is not suitable structural support. Article III,
Section 52-30 A.C.
Inspection completed at approximately 11:50 A.M.
Respectfully submitted,.
Edward Hindermann
Building Inspector
Lv Le'
tilt0 ALTExAT10N OR ADDITlO a
I. Sl1i:VEY IS A VIOLATION OF
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STATE OF NEW YORK)
ss. -
COUNTY OF SUFFOLK)
Premises: No # Love Lane
Mattituck, New York
Town of Southold
WALTER GATZ, MARILYN JEAN GATZ, his wife, and DOROTHY
HAMILTON, all being duly sworn, deposes and say:
That they are all over the age of eighteen (18) years of
age and reside at Mattituck, Town of Southold, Suffolk County,
New York;
That they are the former owners of the premises above
described; (premises recently sold to PETER E. & DEBORAH L. ORLOWSKI)
That WALTER GATZ and MARILYN JEAN GATZ, his wife, acquired
title to the southeasterly part of the premises by deed dated
November 20, 1957, from MARILYN JEAN GATZ f/k/a MARILYN JEAN HAMILTON;
That DOROTHY HAMILTON acquired title to the northwesterly
part of the premises as residuary devisee under the Last Will and
Testament of Lloyd Hamilton, deceased;
That title has remained in possession of the GATZ-HAMILTON
family since 1957 and prior to April, 1957, the effective date of
zoning in the Town of Southold;
That the annexed survey is an accurate representation of
the premises as they existed prior to April, 1957, the effective date
of zoning in the Town of Southold; and no other structures, as defined
by the Zoning Law of the Town of Southold have been erected and no
GATZ AND ARNOFF - ATTORNEYS AT LAW - RIVERHEAD, N. Y.
alteration to any of said structures since the above specified date
has been made;
That the building on said premises up to and including the
date of this affidavit has been used as a one -family dwelling and
remains in an average condition subject to reasonable use, wear, tear
and natural deterioration;
This affidavit is made to induce the Town of Southold,
through its appropriate officials, boards or employees, to issue a
certificate of pre-existing use in reference to the premises herein
referred to; and knowing and intending that the said Town, its
officials, boards or employees will rely upon and be induced to act
by reason of the representations made herein.
DOROTHY H,...-
Sworn to before me this
A day of February, 1978.
Notary
P/tiblic
CAbPERINs"
NOTARY PUB_1C. ` !e oi1� ON,! York
'No. 52-4516381 - Suffol!, Couody
Commission Expires March 30, i971f
GATZ AND ARNOFF - ATTORNEYS AT LAW - RIVERHEAD, N. Y.
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EDUCATION LAW.
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